Nobody dreams of a blue Christmas, but the blues are exactly what some people get at this time of year. It's not easy helping people cheer up, but caring friends and family can do a lot to help a loved one who is depressed.

Dave*, a stay-at-home dad in Toronto, says his wife, Charlene*, becomes less of her normal lively self at this time of year. She becomes more subdued and doesn't react to many of the seasonal celebrations going on around her. She'll pick at her favourite foods, for example, or shrug indifferently when close friends she hasn't seen in a while are due to come over.

While Charlene, a medical doctor, doesn't suffer full-blown depression, she still needs support and sympathy from those around her, says Dave, a trained psychologist. Dave steps in when he sees her grow quiet and hears her frequent sighs, indicating her Christmas-season blahs. He talks to her to find out if there is something specific bothering her.

Unrequited holiday expectations
"For Charlene, it's more a case of expectations not being met," says Dave. Instead of presenting the perfect family on their best behaviour, the kids start acting up because they're excited, and everyone's on edge because Grandma's grumpy after a long trip. Then there's the expectation that people will like their gifts, and the big disappointment when it's clear they don't.

Dave reminds her that things never run perfectly and encourages her to accept what happens in context. If the vegetables are overcooked, it's not the end of the world; if the kids are excitable, that's normal; and if the gifts aren't exactly right, remember that Christmas is about the act of being generous rather than about specific material items.

Talk it out
Talking about the things that cause her stress and finding ways to reduce them helps. Support and sympathy are key in helping her cheer up, he says.
Pam*, a freelance writer in Toronto, sometimes gets hit with a more severe type of depression right about now -- perhaps as a reminder of an incident that happened several seasons ago. Meeting 40 or so relatives of her new husband on Christmas Day five years ago was too much for Pam, who was used to small, quiet gatherings with a family that is more of formal British stock. Her husband's family is Italian, and getting used to a group that, to her, was much more excitable added to her stress. Without telling anyone, she quietly grabbed her coat, left the house and went for a long walk.

"I didn't know where she was, but I covered for her," says her husband, Paolo*, a chef. Pam has a history of depression, and while it's usually under control, once in a while it surfaces. But having a supportive, understanding spouse makes a huge difference in helping her recover from bouts, which can last for weeks at a time. Sometimes Christmas is great; other years it's a tough haul, and the couple never knows ahead of time which it's going to be.

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Being a supportive spouse
Paolo's tactics for helping Pam include massaging her back, brewing her cups of tea and patiently waiting for her to get better. "You can't tell someone to cheer up or snap out it. That can make it worse and show you don't understand the condition," he says.

Paolo has learned to spot the warning signs in his wife. For example, Pam, who is usually quite social, will avoid get-togethers and become unusually tired and listless. That's when Paolo does his best to be extra-attentive without being overbearing.

Arming yourself with information on people who feel depressed and sad around Christmas can also help. Learning as much as you can from books, Internet sites and professional groups goes a long way in figuring out how best to help a spouse, friend or colleague who is feeling sad and depressed.

For many people, the holiday season can magnify an already emotional crisis, says Patricia Harnisch, associate director of the Distress Centre of Toronto. For people who are trying to cope with a difficulty in life, such as a job loss, the holidays can be a time when they feel depressed if this crisis is mixed with expectations of holiday gift giving and socializing. "During this busy time of year, your normal resilience can be stretched to the limit. Being able to talk to someone can help put things in perspective," says Harnisch.

What's driving the blues?
Feeling down during the holidays is caused by a mix of both physiological and social factors, says Dr. Robert Levitan, associate professor of psychiatry at the University of Toronto. Financial problems, rekindling old conflicts in dysfunctional families, being alone when others are seeing loved ones or the guilt of avoiding relatives this time of year can trigger a lot of miserable and complex feelings.

For some the problem is worse than just the blahs. About three out of every 100 people suffer a severe form of seasonal affective disorder (SAD), which is linked to the changing amount of daylight in the winter -- not the holiday season -- while 10 to 20 per cent experience a milder form. The amount of daylight seems to influence the balance of certain mood chemicals, such as serotonin, in the brain. Some people are just more sensitive to changes in daylight. Interestingly, the day with the least amount of light -- Dec. 21 -- seems to mark the point at which SAD starts to gradually worsen for the season, and it's just after New Year's when mood disorder clinics see a high number of SAD cases, says Levitan.

Watch for the signs
As for what to watch for, Dr. Raymond Lam, a professor of psychiatry at the University of British Columbia in Vancouver, says to keep your eyes open for signs of atypical behaviour. "Watch for changes in eating and sleeping habits, and if the person loses interest in things that normally interest him," he says.
Listlessness, frequent crying, irritability and moodiness can be signs that help is needed. Find it from:

• a crisis centre (check the phone book for contact information);
• your family doctor; or
• the local hospital emergency room.

A general tip for this time of year is to not feel like you have to do everything. "Be realistic," about what you can accomplish, says Lam. At the same time, however, the answer is not to avoid everything either. "Maybe schedule things differently," suggests Lam.

For Pam and Paolo, that's exactly what they do. If Pam is having a bad season, they reduce the number of cocktail parties and social visits they go to. Sometimes Paolo goes out solo, or he stays in and they have a quiet night at home instead. It never hurts to take a night off from the holidays.
*Names have been changed.

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How to help a friend in need
Wondering what you should do around a friend you think is mildly or moderately depressed this holiday season?

• Be patient. It can take weeks for a person who is depressed to feel better.

• Be sensitive.

• Offer back rubs, tea or favourite snacks. Small offers of kindness, as
well as engaging in activities that are fun or provide a sense of
accomplishment, go a long way toward lifting spirits.

• Encourage her to see a doctor or therapist if things get really bad.

• If she threatens suicide, take her to a hospital immediately.

• Be a nonjudgmental listener.

• Invite her to activities, even if she may sometimes refuse.

• Continue to call and keep in touch; let her know someone cares.

Here's what not to do
• Don't tell her to just snap out of it. Depression is a medical condition that takes time to heal.

• Don't tell her that you understand why she's depressed; unless you've been there yourself, you don't.

• Don't tell her she will feel better soon. That can be interpreted as proof that you don't understand the disease and can make her feel more alienated.

• Don't be pushy. This can cause a depressed person to withdraw even more.

• Don't be judgmental. Depression is not anyone's fault.

• Don't expect her to be the same as when she is not depressed.

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